Don't know if I am pregnant?

Patient : I am a 42 nearly 43 and have a iud in and have so for coming on five years. Over the last couple of months I have had tender breasts and butterfly twitches in my stomach area , a strong sense of smell and I have been off my coffee which is not like me. I have three children already 21 - 16 and knew straight away that I was pregnant with all three. I have taken two pregnancy tests and they are both negative. I don't necessary want another child but will adore it if it is so.
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